Objective: To observe the clinical efficacy of acupuncture treatment for migraine. Methods: Forty cases were randomly allocated to a treatment group and a control group, 20 cases in each group. Cases in the treatment group were treated with acupuncture, while cases in the control group were treated with oral Sibelium. After that, the changes of cerebral blood flow were observed before and after treatment. Results: There was significant difference in clinical efficacies between two groups (P<0.05). There were also significant differences in arterial blood flow velocities of before and after treatment. Acupuncture can produce substantial differences (P<0.05) in blood flow velocities of vertebral artery (VA), middle cerebral artery (MCA) and anterior cerebral artery (ACA) during an increased flow rate. It can also produce statistical differences in blood flow velocities of VA during a decreased flow rate (P<0.05). Conclusion: Acupuncture can effectively alleviate the pain of migraine sufferers and exert a two-way regulation on the cerebral blood flow.

AIM:R-spondin 2 (Rspo2), one member of R-spondin family which contains four secreted proteins , plays an important role in skeletal muscle development .However, the impact of Rspo2 on vascular smooth muscle cell ( SMC) differentiation is little known . This study aims at revealing the role and mechanism of Rspo 2 on SMC differentiation from embryonic stem cells (ESCs).METHODS:A well-established model for studying SMC differentiation from ESCs were used , in which mouse embryonic stem cells ( ES-D3) were seeded on collagen IV-coated flasks and cultured in differentiation medium (DM) for 2, 4, 6 and 8 days.Smooth muscle specific markers, includingα-smooth muscle actin (α-SMA), SM22 and smooth muscle myosin heavy chain (SM-MHC), were detected to in-sure the successful model by qRT-PCR and Western blot .After 3-day pre-differentiation, ESCs were treated with recombinant Rspo 2 protein, overexpression plasmid or shRNA plasmid for 96 h, and the mRNA and protein expression of smooth muscle markers was detected.To explore the role of Rspo2 on SMC differentiation in vivo, 3-day predifferentiated ESCs (106 in 50μLα-MEM) incubated with Rspo2-overexpression plasmid were mixed with 50 μL of Matrigel ( Becton Dickinson Labware ) and then subcutaneously injected into C57BL/6J mice.After 12 days, mice were sacrificed and the implants were harvested for immunofluorescence staining , qRT-PCR and Western blot.Furthermore, electrophoretic mobility shift assay (EMSA), chromatin immunoprecipitation assay (ChIP) and lucif-erase reporter assay were performed to investigate the transcriptional activity of SMC differentiation related transcription factors , inclu-ding serum response factor (SRF), myocardin (MYO), myocyte-specific enhancer factor 2C (MEF-2C).Involvement of Rspo2 re-ceptor, leucine-rich repeat-containing, G-protein-coupled receptors (Lgr)4,5,6, and β-catenin pathway during Rspo2-induced MSC differentiation were also uncovered by overexpression or inhibition of the respective protein .RESULTS:Our results showed that Rspo 2 mRNA and protein expression was significantly and consistently increased during ESC differentiation towards SMCs .Recombinant Rs-po2 protein and enforced Rspo 2 expression in ESCs resulted in up-regulation of smooth muscle markers and transcription factors , while knockdown decreased the expression of these genes .Expectedly , Rspo2 overexpression also promotes SMC differentiation in vivo.
Mechanistically , our data showed that Rspo 2 could promote SRF binding to SM22 promoter region .Evidence also revealed that one of three Rspo2 receptors, LGR5, was up-regulated while the other two , LGR4 and LGR6, was down-regulated.Silencing of LGR5 inhibi-ted Rspo2-induced SMC differentiation, whereas knockdown of LGR4 had no impact.Finally, activation or inhibition of β-catenin could promote or inhibit SMC differentiation , respectively .CONCLUSION: Our findings demonstrate for the first time that Rspo 2 plays a positive role during smooth muscle cell differentiation from embryonic stem cells .We confirmed that Rspo 2 can up-regulate smooth muscle markers at transcription level .We also revealed Rspo promote smooth muscle cell differentiation through activation of LGR 5 re-ceptor and Wnt/β-catenin pathway .

Cervical adenosarcoma is a very rare type of Mullerian adenosarcoma and it is easily confused with benign polyps, therefore, differential diagnosis is necessary. The primary clinical symptoms are vaginal abnormal bleeding and abdominal pain, which can be prevented through the study of high-risk factors. Surgery excision has been considered as the main treatment at present. Due to the low incidence of cervical adenosarcoma, its etiology, pathogenesis, diagnosis and treatment need to be discussed further. This paper reviews the diagnosis and treatment progress of cervical adenosarcoma.

Objective To investigate the effect of high body mass index (BMI) on perioperative complications under thoracoscope radical resection of lung cancer and its clinical efficacy.Methods A total of 235 patients who received pulmonary radical resection under thoracoscope between January 2012 and December 2017 in Department of Thoracic Surgery of the First Hospital of Lanzhou University were retrospectively analyzed.The patients were divided into normal BMI group (BMI≥ 18.5 kg/m2 and BMI ＜24.0 kg/m2,n =147) and high BMI group (BMI≥24.0 kg/m2,n =88) according to BMI in China.The incidence of postoperative complications and clinical efficacy were compared by using x2 test and t test.Logistic regression was used to identify that if high BMI was the independent risk factor of postoperative pulmonary infection in patients with lung cancer.Results The incidence of the complications in high BMI group was higher than that in normal BMI group,including pulmonary infection [17.0％ (15/88) vs.6.1％(9/147),x2 =7.162,P ＜ 0.05],pulmonary atelectasis [11.4％ (10/88) vs.3.4％ (5/147),x2 =5.840,P ＜ 0.05],respiratory failure [5.7％ (5/88) vs.0.1％ (1/147),x2 =5.535,P ＜ 0.05] and poor wound healing [10.2％ (9/88)vs.3.4％ (5/147),x2 =4.578,P ＜ 0.05].Postoperative recovery time [(7.1±1.4) d vs.(6.7±0.8) d,t =2.706,P ＜ 0.05],chest drainage tube removal time [(3.8±1.6) d vs.(3.4±0.7) d,t =3.089,P ＜ 0.05] in high BMI group were longer than those in normal BMI group.Multiple-factor analysis showed that the independent risk factors were diabetes,high blood pressure,high BMI,long operation time,old age,smoking history (all P ＜0.05).Conclusions The incidence of pulmonary infection,pulmonary atelectasis and poor wound healing for the patients with high BMI is increased.Besides,postoperative recovery time and chest drainage tube removal time are prolonged.High BMI is an independent risk factor of pulmonary infection.

Objective    To investigate the effect of multidisciplinary team (MDT) on perioperative complications and clinical efficacy of patients who were receiver radical operation to treat lung cancer by video-assisted thoracoscopic surgery (VATS). Methods    Eighty patients in the Thoracic Surgery Department of First Hospital of Lanzhou University from December 2017 to February 2019 who were diagnosed lung cancer were divided into two groups. Forty patients in the MDT group were treated with MDT discussion. The control group consisted of 40 patients who were treated without MDT discussion. The incidence of postoperative complications and clinical efficacy were compared between the two groups . Results    There was no statistical difference in incision infection, atelectasis, pleural effusion and pulmonary leakage between the two groups. However, the incidence of postoperative pulmonary infection (5% vs. 20%, P=0.043) and the overall postoperative complications (17.5% vs. 42.5%, P=0.015) in the MDT group was lower than that in the control group with a statistical difference. In the MDT group, the operative time (140.3±8.0 min vs. 148.8±6.8 min, P<0.001), intraoperative bleeding ( 207.8±19.4 mL vs. 222.0±28.3 mL, P=0.010), lymph node dissection number (25.1±6.2 vs. 20.1±7.0, P=0.001), postoperative drainage (273.0±33.5 mL vs. 24.0±52.5 mL, P<0.001), drainage duration (81.9±6.1 h vs. 85.3±8.1 h, P=0.039), pain on the first day after surgery (4.6±0.7 vs. 5.4±0.7), P<0.001), pain on the second day (2.5±0.7 vs.  3.0±0.8, P=0.002), pain on the third day (1.1±0.8 vs. 1.5±0.6, P=0.014), postoperative activity time (40.7±6.7 h vs. 35.3±7.1 h, P<0.001), postoperative recovery time (6.8±0.9 d vs. 7.4±0.7 d, P=0.003), patient satisfaction (8.1±1.4 vs. 7.2±2.0, P=0.020) were significantly better than those of the control group with statistical differences. But there was no statistical difference in the conversion to thoracotomy between the two group. Conclusion    MDT discussion can reduce the surgical risk and postoperative complications, improve the clinical efficacy and accelerate the postoperative rehabilitation of patients, which has a good clinical significance.